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NPI Code Detail

MEDICARE: AMIRA YAGI DDS

MEDICARE: AMIRA YAGI DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryD15391MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003290701
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMIRA YAGI DDS
Provider Business Mailing Address
First Line : 2220 PLYMOUTH AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-3600
Country : US
Telephone Number : 612-543-3525
Fax Number :
Provider Business Practice Location Address
First Line : 2220 PLYMOUTH AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-3600
Country : US
Telephone Number : 612-543-3525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2015
Last Update Date : 06/02/2026

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